Nerve Block Gallery - Popliteal Sciatic Nerve Block
Caption
Popliteal Sciatic Nerve Block A 71 year old woman with dementia and mobility constraints presented with a gaping laceration over the posterior gastrocnemius extending inferiorly towards the achilles after a “fall from wheelchair”. Achilles tendon function was preserved and the wound was explored without foreign body. The patient did not tolerate initial attempts at laceration repair after local anesthesia due to pain and anxiety. A decision was made to perform a popliteal sciatic nerve block. The patient was placed in the prone position and 1% lidocaine without epi was drawn up in a syringe with extension tubing connected to a spinal needle under sterile conditions. A linear probe was used to identify the sciatic nerve just below the adductor magnus muscle. Lidocaine was injected 1 cm distal to the sciatic nerve’s bifurcation into the Common Peroneal N. and Tibial N. using the “in-plane” view. 20mL spread above, below and around the sciatic nerve sheath was sufficient to provide near-complete anesthesia and the patient tolerated the entire laceration repair. Submitted by Dr. Jordan Dow and Dr. Kelly Maurelus, Kings County Medical Center